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11/30/2003 11 :54 FAX y a002/002 <br /> ii_M7� �11) I Q ��q <br /> Rjc'gwjE0 EFlD LOG NUMBER <br /> SAN JoAQUIN COUNTY <br /> Nov. 3 0 2009 ENVIRONMENTAL HEALTH :DEPART <br /> 600 East Main St. Stockton, CA 95202-3 ".;P <br /> LZ 600 <br /> (209)468-3420 Fax: (209)464-0138 Web: .`"jgoV.Org/7 1) <br /> PRRh PUBLIC RECORDS RELEASE APPLICATION 73 <br /> APPLICANT: BUSINESSIAGENCY: • tP4 3EV—'\f if i14 C_ <br /> ADDRESS: ' �3L} ( t— CITYISTATEIZIP: IS-67-1 <br /> PHONE(1): PHONE(z): FACSIMILE: IC qgU-o G O3 <br /> TENTATIVE*APPOINTMENT DATE:_ it(7I39 Time: Q&q <br /> (Please allow 10 business days from data of applisstion submittal-'Tontathm only-must be conflrmad) <br /> RrCHECK BOX TO EXPEDITE REQ - 15 F (CA OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN DATE It /3clln9-- <br /> Electronlc Information: ❑LIS Map—Description: <br /> FILE ADDRESS END USE ONLY <br /> Stnet 1k Streit Name city El Unit 1 <br /> 5'{I tib Tmruy , <br /> 2. L-I P-0 ❑unit 2 <br /> 3. 575- W, L••t tz-� -prc� � C.o <br /> 4, W. tri Z So: �� $ <br /> 7. <br /> s. <br /> kink 5 <br /> 9. <br /> 10. <br /> ❑Unit 8 <br /> Spoe is Data Range of Information Requested: From to <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> :6DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ARATEM:NT ❑SOLID WASTE FAULITYNEHICLE <br /> =us <br /> CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ElWASTE TIRE <br /> OUND TANK(MONm)RafIGIRrMOVAL) ❑DOG•KENNEL []DAIRY <br /> WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACU.TTY ❑MOTELIHOTEL ❑PUMPER TRUCKI1fARDICHEMICAL TOILETS <br /> ❑TATmoIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEW=PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY$:00 AM-5:00PM(EXCLUDINo HOLIDAYS) <br /> 1. List up to ten addresses In thq space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one We type MUST be selected. Fax to(2093 S". 138 or mail to the address indicateg ghmm. Address <br /> ranges will not be accepted-far additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointment$ <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked an by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the some applicant may require a$115 deposit prior•to'revfew. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)4$8-3425. <br /> !HD VE!ONLY <br /> CHO 48-06 07109 <br />